Table 4.
Predictors of treatment dropout among 4,315 adult South Africans who had received mental health treatment in the past 12 months, overall and by sectora
| Type of provider |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Overall (n=675) |
Psychiatrist (N=70) |
Other mental health professional (N=55) |
General medical (N=440) |
Human services (N = 169) |
||||||
| Predictor | OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI |
| 1–2 initial visits (reference: 3 or more) | .4* | .2–.7 | .0* | .0–.2 | .0* | .0–0 | .0* | .0–.1 | .0* | .0–.1 |
| Age (reference: ≥65) | ||||||||||
| 18–34 | 2.0 | .6–6.3 | 16.3 | .2–1,418.8 | .1 | .0–7.6 | 3.1* | 1.1–8.7 | 1.4 | .1–13.8 |
| 35–49 | 1.7 | .6–5.0 | 19.7 | .2–1,620.7 | .0 | .0–2.5 | 1.9 | .6–6.2 | 2.1 | .2–20.1 |
| 50–64 | 1.8 | .6–5.6 | 6.2 | .3–122.3 | — b | — b | 2.0 | .7–5.6 | 2.3 | .3–20.1 |
| Male (reference: female) | 1.3 | .8–2.0 | 2.1 | .5 8.0 | .9 | .0 15.5 | 1.5 | .8 2.7 | 2.0 | .7 6.0 |
| Marital status (reference: married or cohabitating) | ||||||||||
| Separated, widowed, or divorced | .7 | .3–1.3 | — b | — b | — b | — b | 1.6 | .8–3.5 | .3 | .1–1.6 |
| Never married | 1.2 | .8–1.8 | 4.9* | 1.2–19.6 | 1.0 | .1–13.8 | .9 | .6–1.6 | 1.0 | .4–2.3 |
| Education (reference: high) | ||||||||||
| Low | 1.5 | .4–5.2 | — b | — b | — b | — b | 3.2* | 1.1–9 | .5 | .0–4.5 |
| Low-average | 1.4 | .6–3.2 | 5.6 | .0–667.7 | 7.8 | .1–573.6 | 1.8 | .7–4.6 | .3 | .0–2.0 |
| Average-high | 1.3 | .6–2.7 | 126.7 | .8–20,037 | .8 | .0–19.2 | 1.8 | .8–3.9 | .5 | .1–2.3 |
| Household income (reference: high) | ||||||||||
| Low | 1.2 | .6–2.2 | .0 | .0–1.5 | .2 | .0–45.4 | .5* | .3–1.0 | 9.6* | 2.6–35.8 |
| Low-average | .9 | .4–2.2 | — b | — b | — b | — b | .4* | .2–.8 | 4.5* | 1.3–16.3 |
| Average-high | 1.5 | .6–3.6 | — b | — b | — b | — b | .7 | .3–1.6 | 5.9 | .7–51.9 |
| Insurance (reference: none) | 1.5 | .9–2.4 | .5 | .1–2.0 | .8 | .1–10.8 | 1.8* | 1.–3.3 | 1.7 | .7–4.5 |
| Previous mental health treatment (reference: none) | .4* | .3–.7 | .2 | .0–1.5 | .2 | .0–2.7 | .4* | .2–.7 | .6 | .2–1.9 |
| Mental disorder | ||||||||||
| Any mood | 1.6 | .8–3.2 | — b | — b | .1 | .0–20.2 | 2.3 | .8–6.4 | 11.9* | 3.1–45.7 |
| Any anxiety | .7 | .4–1.3 | .0* | .0–.3 | 3.7 | .0–1,011.8 | .7 | .3–1.3 | 3.4 | 1.0–12.0 |
| Any substance | 3.7* | 1.6–8.7 | — b | — b | — b | — b | 3.0* | 1.3–6.9 | 2.4 | .7–8.5 |
| Any impulse | .2* | .1–1.0 | — b | — b | — b | — b | — b | — b | — b | — b |
| Number of disorders | ||||||||||
| Only 1 | — | — | — b | — b | — b | — b | — | — | — | — |
| 2 or more | .9 | .3–2.7 | — b | — b | — b | — b | 1.1 | .2–5.4 | .0* | .0–.3 |
| 3 or 4 providers (reference: 1 or 2) | .1* | .0–.3 | .7 | .1–6.8 | .4 | .0–7.5 | .4 | .1–1.2 | 1.8 | .5–6.0 |
| Complementary-alternative medicine (reference: none)c | 1.3 | .7–2.6 | — b | — b | — b | — b | 1.5 | .8–2.7 | 2.1 | .8–5.2 |
| Type of provider (reference: general medical) | ||||||||||
| Psychiatrist | .1* | .0–.2 | ||||||||
| Other mental health professional | .3* | .1–.8 | ||||||||
| Human services | 1.0 | .6–1.8 | ||||||||
Models are multivariate (all predictors in each column were entered simultaneously) and based on a survival framework (with person-visit file). Each column represents a separate multivariate model of dropout from care in that sector.
Results not shown because of small cell size. Small cell size determined by calculating the expected number of cases based on the percentage of people with the outcome and the total number of people with the condition. If the expected value was <5, then the odds ratio value is indicated by a dash.
Because complementary-alternative medicine was not included in the analysis as an outcome, it was used as a dichotomous (yes-no) predictor in each model.
p<.05 (two-sided)